African HIV patients living 'near-normal lifespan': study

HIV patients in Africa who are receiving regular treatment can expect to live a near normal lifespan, Canadian researchers suggest in the world's first large-scale study to examine HIV patients' life expectancy on the continent.

After studying 22,315 patients who were using combined antiretroviral therapy (cART), scientists from the B.C. Centre for Excellence in HIV/AIDS along with experts at the Universities of British Columbia and Ottawa found that with early initiation and access to regular treatment, those infected with HIV were living about two-thirds of a normal lifespan.

"This is astounding news for people living with HIV in Africa who had been living for several years now and were initially told to go home to plan for their deaths. It changes everything," said lead researcher Dr. Edward Mills, who is also Canada Research Chair in global health at the University of Ottawa.

"There was nothing we could give to them but books to write stories to their kids so their kids would have memories of them. Now we tell them to prepare for a very long life," he said.

Mills' study, published Monday in the Annals of Internal Medicine as the International AIDS Society conference continued this week in Rome, was funded by the Canadian Institutes of Health Research.

Life expectancy at birth for people who don't contract HIV in Uganda, where Mills spent six years studying the disease, is 55 years old and increases as people age healthily. Mills tracked the outcomes of the patients, including 1,943 people who died, to analyze death rate and overall health to determine an HIV patients' life expectancy. Results showed, for the overall study cohort, life expectancy at age 20 was another 26 years. Those who had treatment begin earlier, before their immune systems deteriorated, lived longer.

In contrast, life expectancy at birth in Canada is 81, and HIV patients receiving treatment at age 20 could live for another 49 years.

Mills' team believes the Ugandan study is a fair representation of the situation in the rest of Africa.

Women fared better than men, with life expectancy for men at age 20 hitting another 19 years while women at the same age averaged an additional 30 years.

"(Women) are much better about accessing treatment, they're much better at testing for HIV and they're much better at getting care," Mills said, noting most women are tested while checking for pregnancy.

"We have a very big window for women through reproductive health. We don't have anything like that for men," Mills said.

In Africa, men face a 47 per cent higher death rate compared to women, he said.

The cART therapy, developed by international researchers including Canadians, is more readily available to most African nations, and has expanded to remote areas but it is still not universally accessible.

There are more than 200,000 patients receiving cART in Uganda but another 200,000 are waiting for treatment.

More than 33 million people — roughly Canada's entire population — are infected with HIV worldwide, at least 7,700 people infected with HIV each day and nearly 5,500 die daily from an AIDS-related illness.

Two-thirds of the world's HIV and AIDS patients live in sub-Saharan Africa where only about 40 per cent of HIV-infected people are on treatment.

The universal access target is 80 per cent, Mills said.

Still, with HIV patients living longer lives, experts should prepare to fight the complications aging HIV patients will encounter from heart problems to an increased risk of stroke, Mills said.

"Patients in their late 40s and early 50s develop a high rate of cardiovascular disease and this is something no one's talking about," he said.

Mills applauded several African countries — including Uganda and Lesotho — for their efforts in creating simplified, accessible treatment while he named other nations, such as Congo as Botswana as regions that were overwhelmed by large populations afflicted with the virus.

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